Hungry for help

When Jill Andre started wasting away the summer after seventh grade, her parents hoped to treat her eating disorder at home in Spokane.

They watched everything she put in her mouth. They tried to make her eat. They took her to the pediatrician.

A heart scan revealed that anorexia was killing her. She was hospitalized immediately.

“One day later, I would’ve had a heart attack,” Andre says.

Doctors inserted a tube into her nose to force nutrients into her bare-bones frame. She had to wear it to school.

“That was really embarrassing,” she says.

But those make-do fixes didn’t end her self-imposed starvation. Andre kept getting worse. And her parents didn’t know where to turn.

“There was no place in Spokane to go,” she says.

So, they sent her to an inpatient program in Seattle. And later to a pricy treatment center in Arizona, where she spent nearly five months.

“If I wanted to have really good treatment, I had to be shipped off 500 miles away or 1,000 miles away,” she says.

Experts agree that the best way to treat eating disorders — the deadliest of all mental illnesses — is through a multidisciplinary approach. Medical doctors, mental-health professionals and dietitians must work together to coordinate a treatment plan.

There are a number of such professionals, some with extensive experience treating eating disorders, in the Inland Northwest. But this area has neither an inpatient treatment program, nor an outpatient one. There is no provider referral network for patients seeking help. There isn’t even an eating-disorders support group currently meeting here.

“It’s a bio-psycho-social illness and you have to treat it that way or people just don’t get well,” says Vivienne Dutzar, a clinical dietitian at Sacred Heart Medical Center, who sees mostly patients with eating disorders. “To just treat one leg won’t do the trick.”

For years, Dutzar and other professionals met as part of an eating-disorder task force. The group has since disbanded, without making much concrete progress.

“There’s not one place a person with an eating disorder can say, ‘I’ll call them,’ ” says Stacy Mainier, a Spokane social worker who was part of the committee. “I know (patients) are definitely falling through the cracks.”

Without coordinated treatment resources, it’s up to patients, families and practitioners to put together a plan. And that’s made even more complicated by the very nature of eating disorders, a condition that makes most patients not really want to get better.

“When a depressed person comes in, they want relief,” says Lisa Crouse, a counselor who says patients with eating disorders make up about half of her Spokane practice. “They’re not feeling good where they’re at. They can identify a negative impact on their life because of their depression and they want to be done with it.

“An eating-disorders patient is coming in usually not wanting to let go of it. Usually they’re being pressured or coerced by their parents … You’re having to fight them. It’s like working with an alcoholic who’s court-ordered.”

And for patients who do have the know-how and major financial resources necessary to seek treatment elsewhere, they say there’s little help for them once they return home.

Corissa Carbaugh, 23, of Spokane checked herself into a treatment facility in Billings last October to seek help for her eating disorder and drug addiction.

After 36 days in the program, Carbaugh says she’s no longer battling a drug problem. But bulimia – the cycle of bingeing and purging – remains an ongoing problem for her, in part because she found little follow-up treatment in Spokane, she says.

She stopped going to a dietitian and medical doctor here, and meeting with a counselor was a waste of time, she says.

What would help most is a support group, Carbaugh says, but she cannot find one for eating disorders here.

“It’s something people outside of going through it don’t understand,” she says. “To them it’s really disgusting.”

Carbaugh quit her job as a hairdresser about a month ago. Now she’s not sure what to do.

“So far, I’m not finding anything here in Spokane,” she says. “I just hope one day I’ll just get sick of it and I’ll just stop.”

Dee A. Myers, a clinical psychologist, has worked with patients with eating disorders in Spokane for about 10 years. For many of those years, she ran a support group.

In the last couple of years, though, people simply stopped attending the group, she says. So she had to shut it down.

“I felt really bad doing that,” she says.

Myers offers her patients a sobering statistic when they start treatment: About 60 percent of people with an eating disorder recover “to a pretty functional degree,” she says. Another 20 percent partially recover. The remaining 20 percent do not get better, even with treatment. And of those, about 6 percent will die.

“With clients, they always have that aspect of ‘it won’t happen to me,’” Myers says. “It’s one of those diseases where the lab work can come back normal, normal, normal. It plateaus and then — boom — you have a heart attack and die. It’s a deceptive disease.”

Bill Schumacher knows too well the vicious nature of eating disorders. The 38-year-old Spokane man, who recently moved to the Tri-Cities, dropped 100 pounds during a three-month inpatient alcohol treatment program.

Schumacher, who had always been overweight, didn’t think much of his weight loss at first. Then he realized he could not control his anorexia or bulimia. He has been hospitalized seven times in the last six months because of too little potassium in his blood, which could send his heart into a fatal rhythm.

Schumacher is one of about 10 percent of people with eating disorders who are men. He has had trouble finding a support group to attend, he says, because some women do not feel comfortable having a man in the mix. He doesn’t have the money for inpatient treatment, but even if he did, he says he can’t find a facility that admits adult men.

So, he continues to meet with a dietitian, counselor and doctor. He says he has put on a few pounds in recent weeks, but continues to struggle.

“The big change I can say today is at least I don’t believe I’m going to die of an eating disorder today,” he says.

Those who work with people with eating disorders here say they would love to see improved treatment. They want an inpatient program, solely for eating disorders. They want an intensive outpatient program. They would like to see a therapist-led support group.

But there are no reforms on the way.

“We’re in a huge state financial crisis,” Mainier says. “I can’t see any money coming in the next year or two. I don’t think in this economic environment, we’re going to see a lot of changes.”

Plus, all of the practitioners are so busy with their own caseloads, there’s not much time to launch such a big project, they say.

“We’re all burned out not so much from what we’re doing, but from what we see needs to be done,” Dutzar remembers another therapist telling her.

Jill Andre says she’s at a healthy weight now and has been for several years.

But the 20-year-old junior at Eastern Washington University says an eating disorder will always be a part of her life.

“A lot of people think it’s just a sickness and really, it’s almost like alcoholism,” she says. “You recover from it, but you deal with body issues all your life.”

As with many people with anorexia, even intensive inpatient treatment did not represent a miracle cure for Andre.

She relapsed about five months after coming home and had to have the feeding tube put back in.

Then one day in the 10th grade, when she was home sick with the flu and already at a very low weight, she looked hard at herself before getting into the bath.

“I looked in the mirror and finally saw,” Andre says. “And finally it all clicked.”